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Objective To compare the clinical efficacy of laparoscopoic gastroduodenal perforation repair and tradition-al laparotomic gastroduodenal perforation repair. Methods Clinical information of 64 patients admitted to the surgical department of our hospital from January 2012 to April 2013 who received different approaches of gastroduodenal perfo-ration repair was analyzed respectively, of which 34 patients received laparoscopoic surgery (laparoscopic group) and 30 patients received laparotomic surgery (laparotomic group). The length of hospital stay, hospital costs, operative time, intraoperative blood loss, exhaust time, postoperative usage rate of analgesic drugs and incidence of postoperative com-plications were analyzed comparatively. Results Both groups of patients completed the surgery successfully and were cured and discharged from hospital. None in the laparoscopic group transferred to laparotomy in the middle. The la-parotomic group was lower than the laparoscopic group in the operative time and hospital costs (P<0.05), but the laparo-scopic group was significantly lower than the laparotomic group in the length of hospital stay, intraoperative blood loss, exhaust time, postoperative usage rate of analgesic drugs and incidence of complications (P<0.05). Conclusion In terms of acute gastroduodenal perforation repair, laparoscopoic surgery causes smaller injury, enables faster recovery and has higher safety than traditional laparotomic surgery, thereby worthy of clinical promotion and application.
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ObjectiveTo explore the effects of the temperature of saline for irrigation of peritoneal cavity on expression of transforming growth factor beta- 1 in the peritoneum.MethodsSixty patients scheduled for the laparoscopic repair of gastroduodenal benign ulcer perforation were randomized into two groups then surgically treated with various temperature saline.Peritoneal biopsies were taken at the beginning and end of surgery.Tissue concentrations of total and active were measured using enzymelinked immunosorbent assa technique.ResultsAt the start of surgery,there were no significant differences between groups in the total and active fractions of TGFβ1 (P ＞0.05).At the end of procedure,the peritoneal total( 135.8 ±52.8) pg/mL and active( 136.5 ± 33.0) pg/mL concentrations were significantly lower(P ＜ 0.05) in patients receiving warm normal saline.A light,nonsignificant increase in total(361.3 ± 178.9) pg/mL and active ( 198.3 ± 87.5) pg/mL TGFβ1 levels was observed in patients receiving cold saline(P ＞ 0.05).ConclusionsThe choice of warm normal saline used in irrigation of peritoneal cavity during the laparoscopic operation can decrease peritoneal transforming growth factor beta-1 concentrations.Because of the broad biological effects of TGF31,including regulation of peritoneal healing and oncological processes,this observation may have important clinical perspective.
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Objective To investigate an effective method to treat gastric ulcer perforation with integrated traditional Chinese and western medicine. Methods 117 patients were randomly divided into a treatment group and a control group.The treatment group was treated with acupuncture plus Sanbal Powder, and the control group was treated with conventional western medicine exclusively. Results The two groups showed significant difference in the cure rate, the total efficiency, the average inpatient free, and the relapse rate in three years with P＜0.01. Conclusion The therapy of integrated traditional Chinese and western medicine will shorten inpatient time, alleviate pain and increase recovery rate when treating gastroduodenal ulcer perforation.
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38 ℃),while in the open group,3 patients showed complications,12 had the body temperature over 38 ℃.Conclusions Laparoscopic repair,which is feasible and safety for acute gastroduodenal ulcer perforation,should be the first choice in emergency,while non-surgical treatments and emergency subtotal gastrectomy can be two alternatives.